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Collision tumors of two or more histologically separated neoplasms coexisting at the same anatomical site are rare
pathological entities. We report a case of a 74-year-old female living in a rural resource-limited area who presented
with a slowly growing, asymptomatic ulcerated lesion on the nasal skin. Excisional biopsy was performed with a 5
mm free margin, revealing a collision tumor comprising of basal cell carcinoma (BCC) and well-differentiated
squamous cell carcinoma (SCC). The lesion showed clear separation with no evidence of transitional zones between
the two components, differentiating it from basosquamous carcinoma. The patient underwent surgical excision, with
no evidence of recurrence or metastasis observed during a six-month follow-up. Collision tumors, including both BCC
and SCC, are exceptionally rare, and this represents, according to our knowledge, the first documented case in Iraq.
Management should be tailored to the most aggressive histologic component, in this case, SCC. This case emphasized
the importance of accurate histopathological diagnosis and highlights the need for increased clinical awareness in
underserved regions.